Clinical support

Here’s how constructivism can show up in therapy

Explore how constructivist thinking shapes modern therapy and learn simple ways to bring this approach into your treatment planning.

December 5, 2025

5 min read

You might’ve heard that there are three sides to every story: yours, mine, and the truth. In therapy, you see this play out all the time. Two clients can live through the same event and walk away with completely different versions of what happened and what it meant to them.

That’s the core of constructivism: the idea that people don’t just experience life — they interpret it. Instead of reacting to a fixed reality, they’re constantly making meaning based on their identity, history, beliefs, and relationships.

Let’s take a closer look at what constructivist therapy is, where it already shows up in modern modalities, and how you can use this lens to help clients reshape the stories that are already shaping them.

Key takeaways

Constructivism is the belief that people actively create meaning from their experiences, rather than simply reacting to them.
It shows up in many therapy approaches you may already use — like narrative therapy, ACT, EFT, and SFBT — by helping clients examine, reframe, or rewrite the stories that shape how they see themselves and the world.
It can be especially helpful for clients who feel stuck in a narrative about themselves or those who are navigating grief, trauma, identity transitions, or relationship challenges.

What is constructivist therapy?

Constructivist therapy isn’t one specific “type” of therapy. Instead, it’s a way of thinking about people and their experiences that can show up in many different therapeutic approaches.

Constructivism is the belief that people actively create meaning from their experiences, rather than passively absorbing them. Put another way, reality is something we actively construct. It doesn’t just happen to us — we constantly interpret, define, and reshape reality based on our own beliefs, memories, culture, relationships, and more.

Think of it as if everyone wears a pair of glasses with a unique tint. We all see the world through these lenses shaped by our past experiences, identity, values, and more. Constructivism therapy doesn’t try to remove the glasses — rather, it helps people understand the tint, notice how it affects what they see, and even adjust it when necessary. This makes the constructivism theory in therapy helpful for a variety of concerns, including grief, trauma, identity struggles, and relationship challenges.

Themes of constructivism

We’re all meaning-makers: People are constantly interpreting what happens to them and deciding what it means.
Reality is subjective: Two people may experience the same event, but make sense of it in completely different ways.
People are “authors” of their experiences: The stories people tell themselves shape how they feel, act, and relate to others.
Meaning is co-created: Therapists and clients work together to explore how meaning is made, not just what’s true or false.
Change is reconstructive: Growth often comes from seeing things in a new light or reframing old assumptions.
Context matters: Culture, relationships, and identity influence how meaning is made.

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4 ways constructivism shows up in modern therapy techniques

You may not have labeled your work as constructivist therapy, but chances are good you’ve already used techniques rooted in this way of thinking. Many modern therapy models are built on the idea that people create meaning from their experiences — and that shifting those meanings can support healing and change. Here’s a look at four therapy models where constructivist principles show up most clearly.

Narrative therapy

Narrative therapy is one of the clearest examples of constructivism in therapy. It’s based on the idea that people make sense of their lives through stories — and that these stories influence their emotions, relationships, and sense of identity.

In practice, therapists help clients (especially those healing from trauma) map out their experiences as a chronological narrative, making the events feel less chaotic and more grounded. The therapist supports the client in separating themselves from what happened, exploring how their story was constructed, and asking how they might rewrite those narratives to allow for more agency, resilience, or self-compassion.

Rather than asking “What’s wrong with you?” narrative therapy asks, “How are you interpreting what happened — and how might a different story help you move forward?”

Emotionally focused therapy (EFT)

Emotionally focused therapy focuses on helping clients identify and reshape emotional patterns, especially within their relationships. While it might not seem like a constructivist technique at first glance, EFT is rooted in the idea that people’s emotional responses are based on the meanings they’ve constructed — especially around safety, love, attachment, and belonging.

By helping clients identify and rework those internal meanings, EFT reorganizes emotional experiences and strengthens relational bonds. In that way, it’s deeply constructivist: it supports people in not just feeling differently, but in seeing themselves, others, and their relationships in a new light.

Solution-focused brief therapy (SFBT)

Solution-focused brief therapy leans into the belief that people already have the tools and strengths they need to create change. Instead of digging into problems or diagnoses, SFBT invites clients to imagine a preferred future and then identify the beliefs, skills, and exceptions that can help them get there.

That focus on client-driven meaning-making — exploring what’s possible, what’s already working, and what change would look like — captures constructivism’s core idea that people are active creators of their reality. SFBT helps them build a version of that reality that feels more aligned with who they want to be.

Acceptance and commitment therapy (ACT)

ACT fits well within a constructivist approach because it focuses on how clients relate to their thoughts and feelings, rather than trying to eliminate or “fix” them. It helps people notice and understand the stories they’ve built around their internal experiences — like “I’m a failure” or “I can’t handle this” — and see those stories as interpretations, not facts.

Instead of trying to change or suppress difficult thoughts and emotions, clients learn to step back and see them with more flexibility and distance. From a constructivist perspective, this is all about reframing meaning: shifting from “This thought defines me” to “This is just one interpretation — and I can choose how to relate to it.”

From there, therapists help clients reconnect with their core values and take committed action based on what they care about (and not just what they fear or avoid).

Integrating constructivism into your treatment plan

Regardless of whether or not you identify as a “constructivist therapist,” there are plenty of constructivist principles you can incorporate into how you assess, collaborate, and build treatment plans with your clients.

This approach is particularly helpful when working with clients who feel “stuck” in a story about themselves or their circumstances, or with those who are struggling to make sense of who they are after a major life event, loss, or other transition.

Here are a few practical ways to bring a constructivist lens into your treatment plans and sessions.

Incorporating Socratic questioning

Socratic questioning — a key component of cognitive restructuring — is a type of question that encourages critical reflection. It helps clients dig into how they’re interpreting a situation or belief and what could be shaping that interpretation. Instead of telling clients what to think, you’re guiding them to examine how they arrived at a conclusion and whether it’s the only way to see things.

From a constructivist standpoint, this helps clients identify the “lens” they’re using and consider whether another interpretation might be more helpful. It’s less about disproving a thought and more about opening up new possibilities for meaning.

Example prompts you can use:

What evidence supports this belief? What contradicts it?
What assumptions did you make to get here?
Where do you think that assumption came from?
How might someone else in a similar situation see this differently?

Cultivating mindfulness

Mindfulness gives clients space to notice thoughts, emotions, and physical sensations as they come up — without immediately accepting them as truth. In a constructivist framework, this awareness helps clients observe the “story” they’re telling themselves in real-time and decide how (or if) to engage with it.

By becoming more in tune with their internal experiences, clients can pause, reflect, and choose a response — rather than defaulting to old patterns or meanings. Over time, this creates more flexibility in how they interpret events, emotions, and interactions.

How you can use it in your sessions:

Add brief grounding exercises to the opening of your sessions
Encourage clients to journal about moments of emotional reactivity
Use breathwork or other mindfulness exercises to help clients slow down their automatic thought loops

Setting goals collaboratively

In a constructivist approach, goals are something you build with them. This collaborative process recognizes the client as the expert of their own experiences, values, and progress.

Goals should reflect how the client understands the problem — and what change would actually look like in their life. For example, instead of a generic treatment goal like “Client will work on reducing anxiety,” a goal might be: “Client will speak up at least once during weekly team meetings without rehearsing every word.”

These kinds of therapy goals are tied to the client’s personal meaning-making: what anxiety stops them from doing, what success looks like to them, and how change would show up in the real world (and not just on a symptom checklist).

How you can use it in your sessions:

Translate diagnostic language into lived experience (e.g. shift “reduce depressive symptoms” to “get out of bed and walk the dog three mornings per week”)
Revisit and revise goals together as your client’s story and sense of self evolve
Document progress in the client’s own words and not just in clinical terms

Using reframing and alternate perspectives

Reframing is a simple but powerful tool in a constructivist-aligned treatment plan. It invites clients to step back from their rigid or self-limiting interpretations and consider other ways of understanding a situation — without dismissing their emotional truth or lived experience.

This doesn’t mean offering false positivity. It’s about helping clients widen the frame. For example, a partner neglecting to respond to a text might shift from “They don’t care about me” to “Maybe they’re overwhelmed and haven’t checked their phone.” These subtle shifts help clients see that multiple meanings can exist at once and that they have some say in which one they hold onto.

How you can use it in your sessions:

Practice saying, “What’s one other possible explanation?”
Use “yes, and” reframes to validate and expand perspective
Explore how other people in the client’s life might see the same event

Headway helps you expand your practice

Constructivist therapy depends on presence, trust, and skilled collaboration. That work is much tougher to do when paperwork, scheduling, billing, and other admin tasks demand so much of your time and attention. Headway can help by handling everything from your insurance billing to your session notes. With Headway, you can spend less time managing the logistics of your practice and more time helping your clients make meaning, reframe old narratives, and see themselves (and others) through a new lens.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

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